Treating Migraines and Severe Migraines

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Migraines affect more than 30 million
people, or about 12 percent of the U.S. population. Typically
migraines affect women more than men. Yet up to half of people who get
migraines are not diagnosed. Continue reading to find out if you are one of the
millions who get severe migraines.

Severe and Chronic Migraines

The
symptoms of severe or acute migraine
include pain, which is usually severe and often disabling, as well as intense
throbbing. Some people experience nausea, vomiting, or extreme sensitivity to
noise or light during attacks. Episodes of severe migraine may last from four
hours to three days.

Severe migraine may occur with or without
aura. Aura refers to a perceptual disturbance. Examples include experiencing
nonexistent smells, lights, or sounds. A
migraine is often considered severe when pain, nausea, or other associated
symptoms force a person to avoid normal daily activities. Also, a migraine is
classified as severe if the person affected has a history of two to five
similar episodes. Severe migraine is most common among people 25 to 55
years of age, but even children and teens are susceptible.

A chronic migraine occurs at least 15 days a month, for more than
three months. This type of migraine can cause a substantial loss in productivity, and can result in a poor
quality of life. It’s important to treat acute migraine in order to prevent the
development of chronic migraine.

What Are the Different Types of Headaches?

Virtually everyone gets ordinary
tension headaches. Tension headaches
typically cause a dull pain, as if a tight band is squeezing the head. Triggers
may include:

muscle
tension in the neck and scalp

caffeine
withdrawal

too
little sleep

dehydration

Tension headaches usually respond to
treatment with common over-the-counter pain relievers.

A cluster headache is another, less common, type of headache. Cluster
headaches more often affect men. The headaches are characterized by sudden
severe pain behind or around the eye, on one side of the head. Pain peaks
within 10 minutes, but can last 15 minutes to three hours.

Migraines, which are
considered a neurological disorder, are distinct
from tension or cluster headaches.

Migraine Aura and Migraine Triggers

Some people with migraines report
warning symptoms. This is known as migraine
with aura. Warning symptoms may include blurred vision, seeing “stars,” or
other odd sensations like unpleasant smells before the onset of an attack.
Affected people may even experience slurred speech or other language
difficulties. Temporary loss of vision in one eye has also been reported.

Aura may occur from 10 minutes to one
day before onset of a migraine. In some cases, a person may experience an aura
without having a migraine. Migraine with aura tends to be less severe and
disabling than migraine without an aura.

A number of factors are known to
trigger the onset of migraine episodes. More than half of people who experience
migraine with aura report having at least one trigger for their migraines. Potential
triggers are numerous and may include:

The Science Behind Migraines

A migraine results from a complex
cascade of abnormal events in the brain, which are not yet fully understood by
researchers. However, researchers have been able to determine that the abnormal
activity originates in the body’s largest cranial nerve, the trigeminal nerve.
Changes within this cranial nerve quickly spread to a network of smaller nerves.
These nerves form a web throughout the delicate outer lining of the brain; the dura mater.

Within as little as 10 minutes after
a migraine begins, pain-sensing nerves in this network undergo molecular changes.
This causes them to become hypersensitive to pressure. This hair-trigger
response creates throbbing pain as blood pressure naturally rises and falls
with each heartbeat. Also, certain arteries dilate and blood flow is altered
causing pain-producing chemicals to be released. Some of these changes may
persist even after an attack has passed.

Brain messenger chemicals, dopamine
and serotonin, are also believed to play a role in developing a migraine.

Another new theory suggests migraines may be related to
“abnormal temperature regulation in certain regions of the brain.” The theory
goes on to state, “a migraine attack serves to restore the brain temperature.”

Treating Severe Migraine

Emerging research suggest there’s a small window of opportunity to stop the
progression of molecular changes that result in a migraine. To do this,
treatment must begin within 10 to 20 minutes of the appearance of initial
symptoms. Another window of opportunity closes within one to two hours of
headache onset. After this, the skin of the face and scalp may become
hypersensitive to touch. It’s very important to begin appropriate treatment as quickly as possible for best results.

Numerous drugs are available to treat
migraine. Over-the-counter drugs, like aspirin, ibuprofen, and acetaminophen are
often combined with caffeine to combat mild to moderate migraine episodes.

Doctors may prescribe other drugs,
too. Examples include:

antidepressants

blood
pressure drugs (beta-blockers)

anti-seizure
drugs

ergot
alkaloids

Triptans, a class of tryptamine-based
drugs, have proven quite effective at providing relief from ongoing migraine
headache. Some herbal remedies, like feverfew and butterbur, have shown some
promise in migraine treatment.

There are two main branches
of treatment for migraine. Acute treatments seek to stop a migraine headache or
to reduce its severity or duration while it is happening. Preventive treatments
seek to keep headaches from starting. They also aim to reduce the frequency and
severity of attacks. When a migraine headache is in progress, ending it or
reducing pain and other symptoms is of primary importance.